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Open Access Research article

Maternal-infant relationship quality and risk of obesity at age 5.5 years in a national US cohort

Sarah E Anderson1*, Stanley Lemeshow2 and Robert C Whitaker3

Author Affiliations

1 Division of Epidemiology, The Ohio State University College of Public Health, 336 Cunz Hall, 1841 Neil Avenue, Columbus, Ohio 43210, USA

2 Division of Biostatistics, The Ohio State University College of Public Health, 204 Cunz Hall, 1841 Neil Avenue, Columbus, Ohio 43210, USA

3 Departments of Public Health and Pediatrics and Center for Obesity Research and Education, Temple University, 1801 N Broad Street, Philadelphia, Pennsylvania 19122, USA

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BMC Pediatrics 2014, 14:54  doi:10.1186/1471-2431-14-54

Published: 24 February 2014

Abstract

Background

Poor quality relationships between mothers and toddlers have been associated with higher risk for childhood obesity, but few prospective studies of obesity have assessed maternal-child relationship quality in infancy. In addition it is not known whether the increased risk is associated with the mother’s or the child’s contribution to the relationship quality.

Methods

We analyzed data (n = 5650) from the Early Childhood Longitudinal Study, Birth Cohort, a national study of U.S. children born in 2001 and followed until they entered kindergarten. At 9 months of age, the Nursing Child Assessment Teaching Scale (NCATS) was used to assess the quality of observed playtime interactions between mothers and infants, yielding separate scores for maternal and infant behaviors. Obesity (BMI ≥95th percentile) at age 5.5 years was based on measured weight and height.

Results

The prevalence (95% confidence interval) of obesity at 5.5 years of age was higher among children in the lowest quartile of maternal NCATS score (20.2% [95% CI: 17.2%, 23.2%]) than in the highest quartile (13.9% [11.3%, 16.5%]), but maternal NCATS score was not significantly associated with obesity after adjustment for race/ethnicity, maternal education and household income. The prevalence of obesity at 5.5 years of age was similar among children in the lowest quartile of infant NCATS score (17.4% [14.4%, 20.3%]) and in the highest quartile (17.6% 14.4%, 20.8%]), and was not changed with covariate adjustment.

Conclusions

Maternal-infant relationship quality, assessed by direct observation at 9 months of age in a national sample, was not associated with an increased risk of obesity at age 5.5 years after controlling for sociodemographic characteristics.

Keywords:
Mother-child relationship; Parent–child interactions; Maternal sensitivity; Obesity; Cohort studies; Infancy; Parenting; Body mass index